PDF(Pubmed)
Abstract：
BACKGROUND: Colchicine has been widely used as an anti-gout medication over the past decades. However, it is less commonly used due to its narrow therapeutic range, meaning that its lethal dose is close to its therapeutic dose. The lethal dose of colchicine is considered to be 0.8 mg/kg. As chronic colchicine poisoning has multiple manifestations, it poses a challenge in the clinician\'s differential diagnosis. Historically, the drug was important in treating gout; however, clinical studies are currently underway regarding the use of colchicine in patients with coronavirus disease 2019 as well as its use in coronary artery disease, making this drug more important in clinical practice.
METHODS: A 61-year-old male with a history of gout and chronic colchicine intake was admitted to our Emergency Department due to numbness and weakness of the lower limbs. The patient reported a history of colchicine intake for 23 years. After thorough examination, he was diagnosed with colchicine poisoning, manifesting as neuromyopathy, multiple gastric ulcers and myelosuppression. We advised him to stop taking colchicine and drinking alcohol. We also provided a prescription of lansoprazole and mecobalamin, and then asked him to return to the clinic for re-examination. The patient was followed up for 3-mo during which time his gout symptoms were controlled to the point where he was asymptomatic.
CONCLUSIONS: Colchicine overdose can mimic the clinical manifestations of several conditions. Physicians easily pay attention to the disease while ignoring the cause of the disease. Thus, the patient\'s medication history should never be ignored.
METHODS: A 61-year-old male with a history of gout and chronic colchicine intake was admitted to our Emergency Department due to numbness and weakness of the lower limbs. The patient reported a history of colchicine intake for 23 years. After thorough examination, he was diagnosed with colchicine poisoning, manifesting as neuromyopathy, multiple gastric ulcers and myelosuppression. We advised him to stop taking colchicine and drinking alcohol. We also provided a prescription of lansoprazole and mecobalamin, and then asked him to return to the clinic for re-examination. The patient was followed up for 3-mo during which time his gout symptoms were controlled to the point where he was asymptomatic.
CONCLUSIONS: Colchicine overdose can mimic the clinical manifestations of several conditions. Physicians easily pay attention to the disease while ignoring the cause of the disease. Thus, the patient\'s medication history should never be ignored.
摘要：
背景：秋水仙碱在过去的几十年中被广泛用作抗痛风药物。然而,由于其狭窄的治疗范围，它较不常用，这意味着它的致死剂量接近其治疗剂量。秋水仙碱的致死剂量被认为是0.8mg/kg。由于慢性秋水仙碱中毒有多种表现，这对临床医生的鉴别诊断提出了挑战。历史上,该药物对治疗痛风很重要；然而，目前正在进行关于2019年冠状病毒病患者使用秋水仙碱及其在冠状动脉疾病中的临床研究，使这种药物在临床实践中更加重要。
方法：一名61岁男性，有痛风和慢性秋水仙碱摄入史，由于下肢麻木和无力，被纳入急诊科。患者报告有23年的秋水仙碱摄入史。经过彻底检查,他被诊断为秋水仙碱中毒,表现为神经肌病，多发性胃溃疡和骨髓抑制。我们建议他停止服用秋水仙碱和饮酒。我们还提供了兰索拉唑和甲钴胺的处方，然后让他回到诊所重新检查。对患者进行了3个月的随访，在此期间他的痛风症状被控制到无症状的程度。
结论：秋水仙碱过量可以模拟几种情况的临床表现。医生容易注意疾病，而忽略疾病的原因。因此，患者的用药史不容忽视。
方法：一名61岁男性，有痛风和慢性秋水仙碱摄入史，由于下肢麻木和无力，被纳入急诊科。患者报告有23年的秋水仙碱摄入史。经过彻底检查,他被诊断为秋水仙碱中毒,表现为神经肌病，多发性胃溃疡和骨髓抑制。我们建议他停止服用秋水仙碱和饮酒。我们还提供了兰索拉唑和甲钴胺的处方，然后让他回到诊所重新检查。对患者进行了3个月的随访，在此期间他的痛风症状被控制到无症状的程度。
结论：秋水仙碱过量可以模拟几种情况的临床表现。医生容易注意疾病，而忽略疾病的原因。因此，患者的用药史不容忽视。
